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Vital Pulpotomy

space placeholder
space placeholder.What Is It?.
space placeholder.What It's Used For.
space placeholder.Preparation.
space placeholder.How It's Done.
space placeholder.Follow-up.
space placeholder.Risks.
space placeholder.When To Call a Professional.
space placeholder.Additional Information.
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space placeholder.What Is It?
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A vital pulpotomy removes part of a tooth's nerve tissue. This tissue is found in the pulp, the center of the tooth that contains nerves and blood vessels. A vital pulpotomy removes less pulp than root canal treatment. Vital pulpotomy removes tissue from inside the crown. This is the part of the tooth that you see above the gum line. Root canal treatment removes all of the nerve tissue, including the part in the roots of the tooth, below the gum line.

Vital pulpotomy usually is done in children when decay has reached the crown part of the pulp, but the nerve in the root of the tooth is still healthy. The procedure also is done when the pulp is exposed as a result of injury or trauma. The affected part of the pulp can be removed, leaving the healthy part in the root.

A successful vital pulpotomy relieves sensitivity and pain. It also prevents the supporting tissues around the tooth from breaking down.

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space placeholder.What It's Used For
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If the pulp in the crown of a tooth is injured or decayed, but the pulp in the root is healthy, a vital pulpotomy may save the nerve inside the root from dying.

For your dentist to do a vital pulpotomy, the tooth should not be loose or have any swelling or abscesses around it. If there is swelling or an abscess, another type of treatment may be needed.

Vital pulpotomies can be done in children's baby teeth (primary teeth) or in young permanent teeth. In primary teeth, the procedure is done to keep the primary tooth from being extracted. Extracting a primary tooth before it is ready to fall out can alter the way the permanent teeth come in and may cause problems in the future with the child's bite.

If the pulp of a permanent tooth becomes injured or decayed soon after it emerges, the tooth may require root canal treatment. However, root canal treatment is not done until the tooth's roots are finished growing. In this case, a vital pulpotomy can be done instead. Root canal treatment can be done after the roots finish developing.

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space placeholder.Preparation
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The dentist will take X-rays to review the tooth's position and anatomy, and to see whether the root is infected.

A vital pulpotomy is done using local anesthesia. Sedation also may be used. This can include nitrous oxide or an oral medicine. Sedation may help to calm anxious children or young children who are not able to cooperate.

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space placeholder.How It's Done
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First, the area will be numbed with an injection (shot) of local anesthesia. Then the dentist will use a drill and hand instruments to remove decayed areas from the tooth and gain access to the pulp. He or she will remove damaged pulp and place medicine over the remaining root part of the pulp. The dentist will put in a temporary filling. If the pulpotomy was done on a primary tooth, the dentist may place a crown on the treated tooth.

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space placeholder.Follow-up
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Your child's gums may be sore in the area.

The dentist will check on the tooth during future visits.

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space placeholder.Risks
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Vital pulpotomy has a high success rate. However, failures and other problems can occur.

Some of the medicines used in vital pulpotomy can irritate tissues outside of the pulp. Your child might feel a temporary burning sensation in the area of the affected tooth.

If the tooth's entire nerve is infected, the vital pulpotomy may fail. Your dentist will look for infection during the procedure, but if the nerve is in the early stages of infection it may look healthy.

If the tooth still hurts after a vital pulpotomy, root canal treatment may be needed. This will be done to remove the rest of the affected pulp.

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space placeholder.When To Call a Professional
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Your dentist may prescribe pain medicine, or suggest using over-the-counter pain medicine after a vital pulpotomy. If pain gets worse instead of better several days after the procedure, or if swelling develops, call your dentist.

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space placeholder.Additional Information
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American Association of Endodontists
211 E. Chicago Avenue
Suite 1100
Chicago, IL 60611-2691
Phone: 312-266-7255
Toll-Free: 1-800-872-3636

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